Staff Issues Staff Issues in Blending Clinical Practicein Blending Clinical Practice

Research Into Daily OperationResearch Into Daily Operation

“People are not stressed out because of change …

but because of the way it is done…”

Peter Drucker, 2000

“It ought to be remembered that there is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its

success, than to take the lead in the introduction of a new order of things … The innovator has for enemies all those who have

done well under the old conditions, and lukewarm defenders among those who may do

well under the new.”Machiavelli, The Prince

Staff IssuesStaff Issues

Challenges in ImplementationI. ChangeII. Administration’s Role in the

Change ProcessIII. Staff’s Role in the Change ProcessIV. Training of StaffV. Conclusions

I.I. ChangeChange

Accept it Yourself

Create Receptivity

A.A. WHY?WHY?• Managed Care• Welfare Reform• Regulatory Changes/Compliance• Public Pressure

*It might just help client outcomes!”

B.B. ApproachesApproachesSteps of ChangeSteps of Change

•Equilibrium•Denial•Anger•Bargaining•Chaos

• Depression• Resignation• Openness• Readiness• Re-emergence

Signs of ChangeSigns of Change

•Anger- Acknowledge the feeling- Don’t take on the blame- Distinguish between acceptable feelings and unacceptable behavior

•Stalling/Bargaining- Recognize it for what it is

- Don’t let it dissuade you

•Anxiety- Manage anxiety with information

- Commiserate but don’t be diverted

•Sadness- Encourage the expression of feelings

- Sympathize but don’t give unreasonable hope

•Confusion/Disorientation- Give extra support and reassurance- Allow staff to express the concerns they feel

•Depression- Express your understanding and similar reaction- Give back the ability to exert some level of control over decisions being made

C. MotivationC. Motivation

• Fear - Money• Appreciation - Concern• Desire for different outcomes

*It might just help client outcomes”

Planned Abandonment

• On a regular basis…every organization should sit down,look at every product, service, policy and say – if we didn’t already do this, knowing what we know now –would we still do this?”

• “Organize your abandonment – free resources from being committed to what no longer contributes to performance or produces results.”

Peter Drucker, 2000

D.D. TransformationTransformation1. Planned Abandonment

Anticipating Change Through Planned AbandonmentA. List your 5 top products or services B. For each product or service, ask yourself: “If we

didn’t do this already, knowing what we now do, would we do it?”

C. Based on your answer to the preceding question, which products or services should be abandoned? Why?

D. Pick tentative dates to end those that will be abandoned

E. What might replace the abandoned product or service?

2. Innovation2. Innovation CreativityCreativityVerses the ‘same old thing’

• Explore/focus on unexpected successes• Incongruity – if clients at a certain point

continue to relapse – examine your assumptions. “Insanity is doing ….”

• Process Need “If only we could…If only there was a way …”

• Change in Society/ClientsAre clients today the same as before?

3. Change is an Opportunity3. Change is an Opportunity

• Unexpected successes, failures, & outside events

• Incongruity• Process need• Changes in industry or

market structure• Demographics• Changes in perception,

mood and meaning

• New knowledge, scientific and non -scientific

• What significant changes do you think are likely to occur in the next 5 to 10 years

• Which of these changes might be an opportunity for your organization?

Peter Drucker, 2000

Linking Opportunities to People & ResourcesLinking Opportunities to People & Resources

3. Make notes about the people & resources yourorganization currently has that will enable it to pursueeach of the opportunities.4. What resources does your organization need to develop to pursue theselected opportunities?

Peter Drucker, 2000

1. Who are the ablest, most committed people in the organization to pursuethe identified opportunities?2. If you cannot answer thisquestion, list the people you will consult to help you identify these individuals

••Let Go …Let Go …

Let It Happen …Let It Happen …

Make It BetterMake It Better

II. Administration RoleII. Administration Role

“The administrators cannot make choices for staff…but must give them the opportunity to choose.”

“You can’t manage change … You can only make and be ahead of it.”

“You will find no better way to coach employees on what a new culture must look like than by how you carry yourself.”

Harrison Owen, Open Space Technology, 1992

ChallengesChallenges

1. Institute policies to make the present create the future - Planned Abandonment

2. Provide systematic methods to look for and anticipate change - Organized Improvement

3. Know the right ways to introduce change, inside & outside your organization - Exploit Opportunities

Challenges Challenges -- ContinuedContinued

4. Balance change and continuity - Preserve Trust

5. Motivate and retain top performers and create a positive change mind-set among employees.

To Do ListTo Do List

• Practice Planned Abandonment• Focus on investing in opportunities, not problems• Match opportunities with people• Preserve institutional values/trust

Always go back to the Mission statement• Attract/motivate good employees

What Kind of Leader Are You?What Kind of Leader Are You?“Leaders’ Attitudes Change People”• Reactive: Sometimes Works Results not Guaranteed

Stays the Same• Responsive: Comfortable Don’t fix if it ain’t broke• Pro-active: Impressive Rational Planning

Control Power• Interactive: Visionary See the World

The Big Picture• Inspired: Creative New Ways to Be

When it happens you know it

Understanding Your StaffUnderstanding Your Staff

• Can current staff provide new treatment protocols?

• Which current staff need increased training?

• Will new staff be heard? Integration of Old with New

III. Staff’s Role in Change ProcessIII. Staff’s Role in Change Process

Knowledge Workers

OwnershipOwnership

• Acknowledge change

• Understand that change can and will be beneficial to staff, clients, and agency

• Be part of the change processOwnership reduces change resistance

IV.IV. Training of StaffTraining of StaffTechnology/Strategy

• Improved efficiency of office operations• Greater productivity from staff• Cost savings• Strengthened relationships with constituents• Improved program outcomes• Building of organizational capacity• Enhance service delivery• An increase in civic engagement

Ethics and ValuesEthics and Values

• Respect: Autonomy Courtesy Civility DecencyUnderstanding Acceptance

• Responsibility: Accountability Pursuit of Excellence Self-Restraint

• Caring: Compassion Generosity• Justice & Fairness: Procedural Fairness

Impartiality Equity• Trustworthiness: Honesty Integrity Loyalty

Promise-keeping Avoid Conflicts of Interest

• Use Equipment• Talk to Your Audience• Know Your Audience• Work in Sections• Know Your Material• Love Your Material (or Fake It!)• Boomerang questions back to your audience• Be Positive – Compliment your Audience

Don’tDon’t•ASSUME Anything•Put your audience on the spot•Overwhelm your audience•Overburden the “willing” staff

V. ConclusionsV. Conclusions

Letting Go …

Empowerment of Staff & Agency …

Monitoring Efficacy …

Guidelines for ChangeGuidelines for ChangeGuidelines for Letting Go

• Compensate for the losses – create a win-win situation in reaching for the vision

• Give people information – again and again; give them the opportunity to commit personally as well as listen intellectually

• Define what’s over and what isn’t – be specific

• Show how the endings ensure continuity of what really matters

• Identify who’s losing what

• Acknowledge losses • openly & sympathetically